Upfront Cranial Radiotherapy Followed by Erlotinib Positively Affects Clinical Outcomes of Epidermal Growth Factor Receptor-mutant Non-small Cell Lung Cancer With Brain Metastases.

Autor:	Saruwatari K; Department of Respiratory Medicine, Kumamoto University Hospital, Kumamoto, Japan ksaruwat@kuh.kumamoto-u.ac.jp., Ikeda T; Department of Clinical Investigation, Kumamoto University Hospital, Kumamoto, Japan., Saeki S; Department of Respiratory Medicine, Kumamoto University Hospital, Kumamoto, Japan., Shingu N; Division of Respiratory Medicine, Saiseikai Kumamoto Hospital, Kumamoto, Japan., Imamura K; Department of Respiratory Medicine, Kumamoto Red Cross Hospital, Kumamoto, Japan., Komatu T; Department of Respiratory Medicine, NHO Kumamoto Saishunso Hospital, Kumamoto, Japan., Ushijima S; Department of Respiratory Medicine, Kumamoto Chuo Hospital, Kumamoto, Japan., Maruyama H; Department of Respiratory Medicine, Japan Organization of Occupational Health and Safety, Kumamoto Rosai Hospital, Kumamoto, Japan., Kashiwabara K; Department of Respiratory Medicine, Kumamoto Regional Medical Center, Kumamoto, Japan., Tomita Y; Department of Respiratory Medicine, Kumamoto University Hospital, Kumamoto, Japan., Ichiyasu H; Department of Respiratory Medicine, Kumamoto University Hospital, Kumamoto, Japan., Fujii K; Department of Respiratory Medicine, Kumamoto University Hospital, Kumamoto, Japan., Sakagami T; Department of Respiratory Medicine, Kumamoto University Hospital, Kumamoto, Japan.
Jazyk:	angličtina
Zdroj:	Anticancer research [Anticancer Res] 2019 Feb; Vol. 39 (2), pp. 923-931.
DOI:	10.21873/anticanres.13195
Abstrakt:	Background/aim: The optimal treatment strategy for epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) patients with brain metastasis (BM) has not yet been fully determined. The aim of this study was to investigate the optimal management of EGFR-mutant NSCLC patients with BM. Patients and Methods: A multicenter retrospective study was performed on the clinical outcomes of 81 advanced/recurrent EGFR-mutant NSCLC patients with BM treated with EGFR-tyrosine kinase inhibitors (EGFR-TKIs) (gefitinib n=52 or erlotinib n=29). Results: Among the 81 patients, 30 patients received upfront cranial radiotherapy (CRT) and 51 did not. The multivariate cox analyses revealed that the use of erlotinib and upfront CRT were independent predictive factors for overall survival (OS) (erlotinib: HR 0.21; 95% CI, 0.10-0.48; p<0.001; upfront CRT: HR 0.42; 95% CI, 0.20-0.88; p=0.022). Conclusion: Erlotinib and upfront CRT were associated with a favorable prognosis among EGFR-mutant NSCLC patients with BM. Upfront CRT followed by erlotinib may be an appropriate initial management approach for EGFR-mutant NSCLC patients with BM. (Copyright© 2019, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)
Databáze:	MEDLINE
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